SEC Form 3
FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 09/24/2020 | 3. Issuer Name and Ticker or Trading Symbol PMV Pharmaceuticals, Inc. [ PMVP ] | |||||||||||||
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. If Amendment, Date of Original Filed (Month/Day/Year) | ||||||||||||||
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Series Seed Preferred Stock | (1) | (1) | Common Stock | 1,620,101 | 0.00 | I | See footnote(2) |
Series A Preferred Stock | (1) | (1) | Common Stock | 3,488,398 | 0.00 | I | See footnote(2) |
Series B Preferred Stock | (1) | (1) | Common Stock | 1,040,654 | 0.00 | I | See footnote(2) |
Series C Preferred Stock | (1) | (1) | Common Stock | 265,203 | 0.00 | I | See footnote(2) |
Explanation of Responses: |
1. The shares of each of the Series Seed Preferred Stock, Series A Preferred Stock, Series B Preferred Stock and Series C Preferred Stock shall automatically convert into shares of Common Stock on a one to one basis immediately prior to the completion of the Issuer's initial public offering of Common Stock and have no expiration date. |
2. The shares are directly held by InterWest Partners X, LP ("InterWest X"). InterWest Management Partners X, LLC ("IMP X"), as the general partner of InterWest X, may be deemed to beneficially own the shares held by InterWest X. The Reporting Person is a managing director of IMP X, and as such may be deemed to beneficially own the shares held by InterWest X. The Reporting Person disclaims beneficial ownership of such shares except to the extent of any pecuniary interest therein. |
Remarks: |
/s/ Karen Wilson, Attorney-in-Fact for Arnold L. Oronsky | 09/24/2020 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |